Jaundice Outbreak in Biratnagar Municipality of Eastern Nepal: A Microbiological perspective

Nimesh Poudyal, Lok Bahadur Shrestha, Tejendra Pandit, Dipesh Tamrakar, Deepak Yadav, Madhab Lamsal, Basudha Khanal

Abstract


Background and Objectives: Hepatitis is a common cause of jaundice. Hepatitis A and Hepatitis E are enterically transmitted viral diseases. This study investigated an outbreak of viral hepatitis at Biratnagar, Morang district, Nepal, during April 2014.

Materials & Methods: An expert team from Microbiology and Public health of BPKIHS inspected the area and blood samples from 90 suspected cases of jaundice were obtained and subjected for IgM and IgG antibody detection against HAV and HEV. Water samples from 10 different areas of affected region were also collected and checked for presence of coliform by membrane filtration method to confirm the suspicion of fecal contamination of water supply. 

Results: An outbreak Hepatitis E and Hepatitis A occurred in Biratnagar. Out of 90 blood samples, 45 were reactive for hepatitis E IgM, nine were reactive for Hepatitis A IgM. Three samples among these were reactive for both Hepatitis A and Hepatitis E. The liver function tests of the positive cases were deranged while the negative cases had normal LFT.  Among the 10 water samples, five of them grew coliforms which confirmed the fecal contamination of drinking water supply.

Conclusion: A large outbreak of Hepatitis A and Hepatitis E occurred in a Biratnagar which had spread through the drinking of contaminated water. The outbreak was confirmed both by Epidemiology and Disease Control Division of Nepal government and BPKIHS which led to the identification of source and control of the outbreak.


Keywords


Jaundice, HAV, HEV

Full Text:

PDF

References


. John S, Pratt DS. Jaundice. In: Fauci As, Loscalzo J, Kasper DL, Hauser SL, Longo DL, Jameson JL, Editors. Harrison’s Principles of Internal Medicine. 19th Ed. New York: Mcgraw Hill; 2015. 58:279-85.

. Sarguna P, Rao A, Sudha Ramana KN. Outbreak of Acute Viral Hepatitis due to Hepatitis E Virus in Hyderabad. Indian Journal of Medical Microbiology. 2007;25(4):378-82.

. Tandon BN, Gandhi BM, Joshi YK, Irshad M, Gupta H. Hepatitis Virus Non-A, Non-B: The cause of a major public health problem in India. Bulletin of The World Health Organization. 1985; 63(5): 931-4. [2536439].

. WHO. Hepatitis E. Department of Communicable Disease Surveilance And Response. 2001.

. Averhoff F, Khudyakov Y, Bell BP. Hepatitis A Virus. In: Benett JE, Dolin R, Blaser MJ. Editors. Mandell, Douglas and Bennett‘S Principles and Practice of Infectious Disease. 8th Ed. Philadelphia, Pa: Elsevier Sanders; 2015; 176: 2801-24.

. Shrestha SM. Hepatitis E in Nepal. Kathmandu University Medical Journal. 2006; 4(4): 530-44.

. WHO. Hepatitis E. Fact Sheet N°280, Updated July 2015. Website Browsed on Sept. 23, 2015. www.who.int.

. Shrestha Sm. Liver Diseases In Nepal. Liver Foundation Nepal. . Kathmandu Univ Med J. 2005; 3(2): 178-80.

. Shrestha Sm, Shrestha S, Tsuda F, Nishizawa T, Gotanda Y, Takeda N, et al. Molecular Investigation of Hepatitis E Virus Infection in Patients With Acute Hepatitis in Kathmandu, Nepal. Journal of Medical Virology. 2003;69(2): 207-14.

. Awsathi S, Rawat V, Rawat CM, Semwal V, Bartwal Sj. Epidemiological investigation of the jaundice outbreak in Lalkuan, Nainital District, Uttarakhand. Indian Journal of Community Medicine: Official Publication of Indian Association of Preventive & Social Medicine. 2014; 39(2): 94-7.

. Xu B, Yu HB, Hui W, He JL, Wei LL, Wang Z, et al. Clinical Features and risk factors of acute Hepatitis E with Severe Jaundice. World Journal of Gastroenterology. 2012;18(48):7279-84. [3544030].

. Banerji A, Sahani A, Rajiva., Nagendra A, Saiprasad G. Outbreak of Viral Hepatitis E in A Regimental Training. Med J Armed Forces India. 2005;61:329-9.




DOI: http://dx.doi.org/10.7439/ijbr.v8i11.4401

Article Metrics

Metrics Loading ...

Metrics powered by PLOS ALM

Refbacks

  • There are currently no refbacks.




Copyright (c) 2017 International Journal of Biomedical Research

Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.